Healthcare Provider Details

I. General information

NPI: 1598901498
Provider Name (Legal Business Name): VICKI S STEINLEY LPC, CADC III
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: VICKI STEINLEY WELTON LPC, LADC

II. Dates (important events)

Enumeration Date: 12/23/2008
Last Update Date: 04/13/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

272 MEDICAL LOOP SUITE E
ROSEBURG OR
97471
US

IV. Provider business mailing address

272 MEDICAL LOOP SUITE E
ROSEBURG OR
97471
US

V. Phone/Fax

Practice location:
  • Phone: 541-440-3532
  • Fax: 541-440-3554
Mailing address:
  • Phone: 541-440-3532
  • Fax: 541-440-3554

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberC2681
License Number StateOR
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number2681
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: